IN THE UNITED STATES BANKRUPTCY COURT FOR THE WESTERN DISTRICT OF PENNSYLVANIA In Re: Debtor Movant v. Respondent (if none, then "No Respondent") : : : : : : : : : : : Bankruptcy No. Chapter Related to Document No. Hearing Date and Time: CERTIFICATE OF SERVICE OF (Specify Document Served) I certify under penalty of perjury that I served the above captioned pleading on the parties at the addresses specified below or on the attached list on (date) ______________________________________________. The type(s) of service made on the parties (first-class mail, electronic notification, hand delivery, or another type of service) was: ____________________________________________________________. If more than one method of service was employed, this certificate of service groups the parties by the type of service. For example, the full name, email address, and where applicable the full name of the person or entity represented, for each party served by electronic transmission is listed under the heading "Service by NEF," and the full name and complete postal address for each party served by mail, is listed under the heading "Service by First-Class Mail." EXECUTED ON: ________________________ By: ____________________________________________________ Signature ____________________________________________________ Typed Name ____________________________________________________ Address ____________________________________________________ Phone No. ____________________________________________________ List Bar I.D. and State of Admission PAWB Local Form 7 (07/13) American LegalNet, Inc. www.FormsWorkFlow.com